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Tuesday, February 27, 2018

Strengthening the Tripod Fingers for Handwriting


The Tripod Grasp, as the name implies involves grasping a writing tool using three fingers, which likens it to the three-legged device that stabilizes a camera. The tripod grasp is considered the most efficient for pencil control and endurance. However, developing the tripod grasp is a gradual process beginning with fine-motor activities that strengthen the "tripod fingers"- the index, middle fingers and thumb. 

Typically developing children between 1 and 1 1/2 year grasp a pencil inside the palm. Between 2 and 3 years of age they begin grasping it with all the fingers and thumb facing downward. By 3 years of age they typically begin grasping near the pencil point between the index and middle fingers and thumb- forming a tripod. Over the next years of practice the tripod grasp refines so that the pencil is held with greater precise and control.

Strengthening the "Tripod Fingers"


Here are just a few activities that  develop coordination and finger strength as children  press or squeeze between these fingers.



1) Pushing pennies or buttons into a slot in container lid or opening in a tennis ball
2) Pushing pegs into a Lite Brite Board
3) Removing tiny objects from putty or clay.
4) squeezing clothes pins or chip clips. The little girl in the photo is removing squeeze pins from a horse's mane.
5)  Use of tongs to pick up small objects, the game Operation uses tongs.


One of the easiest strategies is to provide thick, short crayons to grasp. The child will have to grasp using the fingers as opposed to grasping a marker inside the palm. Wiping a dry erase board with a small rag and erasing pencil marks with a kneeded eraser also strengthen the tripod fingers.



The following videos demonstrate a few of my home made manipulation tasks that strengthen the "tripod fingers".  But there are also lots of activities and toys on the market that develop these skills.  Here are a few more:
1) Dressing dolls with fasteners
2) Coloring with a small crayon over sandpaper or raised textures. It will take force to make the textures show up on the paper.
3) Weaving, lacing and stringing beads
4) Screwing/unscrewing nuts and bolts or containers with caps
5)  Legos, Tinker Toys, Knex and other construction toys
7) ripping paper or fabric for arts and crafts projects



Source: Strengthening the Tripod Grasp Fingers by RecyclingOT



Source: Strengthening the Tripod Grasp Fingers by RecyclingOT

Source: Make-Your-Own Lacing Cord Activities by RecyclingOT

Working in the Vertical Plane


One easy strategy that occupational therapists frequently recommend is to adapt activities to play and work on vertical surfaces. You can see in the above photo that the Lite Brite toy is perfect for this.  Coloring and writing on vertical surfaces puts the wrist in the best anatomical position (wrist extension) for pencil control.  Here are a few, fun vertical plane activities for young children:
1) coloring on a large, refrigerator size box
2) use of white and black, felt boards on the wall.
3) attach a Lego board to the wall
4) Paint on large easel or paper on wall
5) bathtub paint to use on tub walls
6) paint the house, shed or garage with water and brush



Source: Bottle Coloring and Erasing to Develop Pencil Control by RecyclingOT

Source: Recycling Occupational Therapist demonstrates Fidget Spinner by RecyclingOT

Friday, February 23, 2018

Adapting Ring Stacks with Small variations Builds Fine-Motor Skills


Rings stacks can be extremely simple, yet adapted to teach many skills. Typically developing babies often play with the popular nesting ring stacks during their first year.  A ring stack can be as simple as a tube wedged inside a container so that rings can be placed on top and not fall off.  I have used my own arm as a ring stack during therapy and the Princess Wand shown below. I love using the wand with children because after they release the ring, I can activate it to flash lights, make sounds and vibrate. These types of sensory rewards can be very motivating when trying to engage children with attention challenges.
I cut the ring shown in the photo out of a detergent bottle.

The ring stacks shown below demonstrate just a few ways the common ring stack can vary.....
1) they may require nesting by size, largest to smallest or not require size discrimination at all because the rings are the same size
2) the rings and stack may be made out of plastic, wood, soft vinyl or fabric-providing different tactile  sensory experiences.
3)The rings may be designed to squeak when squeezed
4) made out of a material safe for a baby to mouth and
5) the ring stacks may vary in the number of rings nested; of course the greater the number of rings- the more complex.







Ring stacks teach spatial relationships-how objects fit together and children build on these skills as they fit complex shapes into shape sorters and fit their feet into shoes. I have found it very helpful to explore adaptations to ring stacks when working with children and adults with disabilities. I can make rings to be as large as necessary to compensate for decreased eye hand coordination.  The little boy in the photo is placing rings on top of a cat toy. The mouse is on a spring and squeaks when moved. He was motivated to engage in order to hear the mouse.

The ring stack made out of a toy sword (I bought this one at a Dollar store)  requires stabilizing with one hand while placing the rings. The child in this photo is visually attending better than usual because  he is reaching and stretching, getting some movement sensory stimulation while engaged in stacking the ring.

In addition, I cut these rings in a rectangular shape so that he must orient the shapes to fit onto the sword. this adds a higher level cognitive demand.


I often adapt tall ring stacks to use with adults to promote visual attention and an upright posture.  The following videos demonstrate a few more variations. The Frisbee Ring Stack requires using force, so the resistance provides sensory stimulation and builds strength.




Source: Sensory Frisbee Ring Stack by RecyclingOT

The bilateral ring stack encourages people to use both hands together, developing bilateral coordination. The one shown in the video makes a beep when they press down hard. I attached a squeaky toy to the bottle so that they have to push down using force to make it squeak. Many children and adults with developmental disabilities, including autism spectrum disorders enjoy the proprioceptive sensory stimulation to muscles and joints as they use force.



Source: Bilateral Ring Stack for Individuals with Developmental Disabilities by RecyclingOT

The stretchy cord ring stack requires pulling the ring shapes that are attached to cord and then stacking them onto the stacking piece in the center. It provides a great deal of sensory stimulation as they pull and even more when the ring stack consists of a motorized toothbrush.



Source: Stretchy Cord Ring Stack for Individuals with Developmental Disabilities by RecyclingOT

The Twirly ring stack takes a great deal of motor control to place and release the rings. Many of my clients with autism enjoy watching the shapes spiral downward.


Source: Visual Stimulation Ring Stack for Individuals with Autism by RecyclingOT

The curvy ring stack made out of a bird mister provide a different type of visual sensory stimulation, reaching and requires using hands together to coordinate placement.

Source: How to make this helpful toy for children with autism by RecyclingOT

Ring stacks can be straight or curve such as the  "candy cane " ring stack shown in this video. It vibrates making it especially motivational fun and sensory based.

Source: How to Make Vibrating Candy Cane Ring Stacks for Children with Autism by RecyclingOT

Many of my clients with developmental disabilities love the paint roller ring stack. It feels great to roll between placements. It also develops motor planning skills because it can be tricky to make the rectangular shapes fit and go down this ring stack.



Source: Paint Roller Ring Stack for Children with Autism by RecyclingOT

This is just a sampling of some adaptations I have made by using the simple, familiar skill of placing a ring over a stack and adding challenges that motivate, meet sensory needs and build hand skills. Check out my books to learn more.....

Saturday, February 17, 2018

Visual Stimulation Activities that Help Individuals on the Autism Spectrum

Children and Adults on the autism spectrum often love visual stimulation. They may seek it out by staring at moving lights or flapping their hands near their face. The following  activities are designed to provide visual sensory stimulation that people seek while at the same time promote
1) using hands together (bilateral coordination)
2) visual skills such as tracking or convergence
3) Motor control
4) social skills when used with a partner

Fidget Spinners

Fidget spinners have been very popular over the past year. Some children find them calming and since they are motivating, they can be used as a reinforce (a reward) after completing a task... perhaps homework or a chore.


The video demonstrates a few ideas on how to utilize this motivating toy to develop grasps to effectively use scissors and pencil.  At the same time children receive the pleasure of visual stimulation as they watch it spin...




Zoom Ball 



Zoom ball develop coordination and motor planning as players alternate moving arms apart and together. As players maintain their gaze on the moving "ball" their visual system is stimulated. Their eyes converge as the ball moves toward the face and diverge as the ball moves away from the face. Developing these visual skills help children to keep their eyes on a ball and other objects during sports games.  The video demonstrates how to make this game. 





Spiral Ring Stack 


This is a fun visual activity that also develops motor control. The rings are positioned at the top of a spiral shape and then when released they rapidly spiral downward.

These are easy to make but you have to buy the helicopter toy (see amazon link below) to get the plastic piece that the rings spiral down. Wedge the spiral piece inside the top of a bottle. You may need to cut a small hole inside the bottle cap and then wedge it inside and secure with tape. 
Cut lots of pretty, colorful plastic shapes from containers or lids and then cut a small notch in the center. 


Some individuals who seek visual stimulation really like this- it meets their sensory needs....












Source: Visual Stimulation Ring Stack for Individuals with Autism by RecyclingOT
Source: Visual Stimulation Ring Stack for Individuals with Autism by RecyclingOT





Spiral Ring Stringing

The young man shown in the photo is stringing small rings onto the tip of a water hose coil. He enjoys watching them spiral downward.  I attached a bean bag to the bottom so that he can stand on it while pulling the coil upward. The pulling upward provides additional sensory stimulation to his muscles and joints and develops balance. 
He really enjoys watching the rings spiral down. This seems to be relaxing and decrease agitation. 


Source: Sensory Processing Disorder Activity: Stringing Coiled Hose by RecyclingOT

There are lots of tracking tube toys on the market. I made this one by twisting a coat hanger into a spiral shape. I pushed the hanger through the clear plastic tube, added some marbles and covered the two ends. This makes a cool sound as well as providing visual stimulation. In addition, if you wedge the tube inside a box or bottle you can use it as a ring stack.

I bought this tube at a hardware store. They were sold to hold the long florescent light bulbs and were only a couple of dollars.

I include a few Amazon links to products described in this post. If you order on AMAZON through my links, I make a few pennies....






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Tuesday, February 6, 2018

Simple Weaving Shapes for Children with Autism or other Disabilities

Weaving is the process of interlacing threads by going over and under each other. I use a similar process when I cut slits in a plastic shape and "weave" a longer strip through it. This photo shows my son holding one I made over 20 years ago!

I realized that if I make one end a bit bigger, the insertion strips will look like lollipops and when pulled in place tightly, won't slip through the notches and come out easily.




This activity continues to be easy to make and beneficial when used at work with adults with developmental disabilities. However,  young children with or without disabilities will reap the benefits of watching you make this manipulation activity to use at home or for therapy.






Weaving the shapes together
  • strengthens hands and fingers
  • promotes bilateral hand use
  • develops eye-hand coordination 
  • teaches the spatial relationships of going in and out, over and under... 
  • may involve color and/or size matching
  • provides a repetitive fine- motor task that some individuals will find relaxing
Taking the pieces apart is easier than putting them together and some individuals may only learn this aspect of the task.  Use thicker, stiffer plastic if you want th
e person to use force.  This makes the activity "resistive" and provides sensory stimulation to muscles and joints. Try using the vibrant, strong plastic from coffee containers, plus it smell great! See the Amazon links below.

One of my clients loves to rip paper, especially cardboard. Pulling these shapes apart to push into a small container lid opening appears to meet her sensory needs.
For some clients-I may choose to use a container with a large opening so that insertion is easy. Over time I may add a lid with a large slot opening and eventually use a more challenging lid with a thin opening so that force is required to push the shape inside.

Notice that the individual in the video must pull the pieces apart or they will NOT fit into the slot. There is some built-in problem-solving required in order to be successful.

Also notice that I positioned the container next to the pink vibrating cushion so that he can feel the vibration while working.  You may choose to put some type of vibrating object inside the container. Either way vibration often motivates children or adults with disabilities to engage in hand activities.   


Source: Simple Weaving Shapes for Children with Autism by RecyclingOT

 Placing or removing the worms from the apples works on similar fine-motor skills. However, the openings are quite large and force is not required.... Fall is a great time to incorporate this pretend play into your hand activities.....
Source: Make Your Own Apple Toys for Preschoolers by RecyclingOT

Another option is to attach or remove arrows from valentines. I love the creative options when creating my own materials and your children or clients will, too ❤


Source: Make-your-own Valentine Hearts and Arrows by RecyclingOT




Don't have time to make toys?
http://www.barbarasmithoccupationaltherapist.com/weavabletoys.html